Medical Research Future Fund - A Nation-Building Opportunity

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This article was published in our Spring 2014 edition of Australian Hospital and Healthcare Bulletin. In light of the Medical Research Future Fund (MRFF) passing Senate last week, we have republished it to remind you of the key issues under discussion.
There is no question that Australia is a world leader in health and medical research. Discoveries made here are well documented, including IVF treatments and the manufacturing process for antibiotics developed by Howard Florey. However, these celebrated achievements are themselves only the tip of the iceberg. Thousands of other discoveries have led to improvements in therapies, drugs, clinical practice and health behaviours that have transformed the world’s health. They are fundamental to Australians enjoying one of the highest life expectancies on earth. The Medical Research Future Fund can only help us to continue in this vein.

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The Medical Research Future Fund (MRFF) was put forward by the Federal Government as part of its Budget in early 2014. The proposed MRFF is a sovereign fund that will eventually build to $20 billion, which would deliver $1billion in annual funding to health and medical research in Australia by 2022. The MRFF would effectively double government funding to health and medical research.
If you look beyond the political rhetoric, as well as the speculation about how the money should be spent and in what areas, fundamentally the fund has value and yet very few people, including those in the medical and health sectors, have acknowledged that to the degree it deserves. For those of us who work in medical research, our scientific work has always been based on evidence; on rigorous analysis and robust peer-review; and if we apply this same scientific lens to criticism of the future fund, perhaps we might see the broad benefits that it offers.
In the minds of many, it makes more sense to spend our limited public funds on healthcare, especially when it comes to the vulnerable in our community. Yet those who work at the coalface, where laboratory and bedside meet, know that healthcare and medical research are intrinsically linked. Scientific research underpins the modern health system. There is significant international evidence that hospitals and healthcare facilities that do research derive enhanced patient outcomes and health system efficiencies. A key theme in the Strategic Review of Health and Medical Research presented to the Federal Government in 2013 was that the best performing health systems are those that embed research in health delivery, leading to better health outcomes. A case in point is the work of the Australian Nobel Laureates, Robin Warren and Barry Marshall, who made a remarkable and unexpected discovery of the bacterium, Helicobacter pylori. As a result of their discovery, peptic ulcer disease is no longer believed to be caused by stress and lifestyle factors, but a disease that can be cured by a short regimen of antibiotics and acid secretion inhibitors. Critical to this discovery was the participation of health professionals in research.

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“Australian discoveries in health and medical research, such as the Gardasil vaccine against cervical cancer and the Cochlear hearing implant, demonstrate Australia is well and truly capable of discoveries that have a transformational impact on the health of our community.”
PROF BRENDAN CRABB

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Some people say that the medical research discoveries and cures of the future will come from beyond our shores. I dispute this. Australian discoveries in health and medical research, such as the Gardasil vaccine against cervical cancer and the Cochlear hearing implant, demonstrate Australia is well and truly capable of discoveries that have a transformational impact on the health of our community.
At the Burnet Institute, where I work, researchers have developed a point of care CD4 test, which is now being manufactured in the UK and is in field trials in three countries. The test, which overcomes the major barriers to anti-retroviral therapy, stands to benefit approximately seven million of the world’s poorest HIV positive people. This is an example of how research done on HIV overseas is enhanced and developed in Australia. We may not always make the initial discovery in Australia, but we often enhance the research done overseas, rapidly, and in many cases are able to adapt to our healthcare system needs.
The benefits of scientific research are also visible among our Indigenous communities, where life expectancy is improving and, for the first time, closing the gap in the coming decades is within reach. But the health needs of Australian Aboriginal and Torres Strait Islander people are unique, and will not be addressed by research conducted in Europe or the United States. Most doctors in the developed world have rarely encountered a case of Rheumatic Heart Disease, for example, and yet rates of this condition among our Indigenous communities are some of the highest documented in the world. Australian researchers are working to eradicate this potentially fatal form of childhood heart disease but without continued investment, health improvements will likely decline.
Health and medical research requires substantial investment that is not driven by profit. Much early-stage discovery work is simply too premature for commercial investment and would not occur if left to the private sector. Further, much valuable medical research does not lead to marketable discoveries. Just one example is the Australian research that established the link between stomach sleeping and Sudden Infant Death Syndrome; it is impossible to calculate the number of lives saved from this important discovery, but by its nature it could never result in commercial success.
Research continues to deliver increased life expectancy and better quality of life for Australians with a reduction in disability, particularly for the aged. Australian research informs policy; it informs diagnosis, treatment and prevention – all of which contribute to a better quality of life for Australians. One of the world’s largest longitudinal population-based health studies was conducted by Melbourne’s Baker IDI to examine the health of Australians over 12 years with regards to heart and kidney disease, diabetes and obesity. This research is critical in guiding how best to spend health dollars, where to invest in treatment and how Australians can play an important role in improving their health. This work also informs what clinicians should be talking about with their patients and what tests they should be doing to prevent complications and disability. This is not pie-in-the-sky research but work that has a direct bearing on people’s health today.
At present many of Australia’s scientists spend up to a third of their time applying for funding – do we really want someone who is potentially working on the cure for cancer doing paperwork instead of looking through a microscope? I would hope not.
The potential of the Medical Research Future Fund is enormous. Yes, there are questions to be answered about the fund, including how it will work and what areas it will fund, but we shouldn’t lose sight of the bigger picture. Australia has one of the best healthcare systems in the world, and research underpins that. The potential to do much, much more is truly exciting. The Medical Research Future Fund is a game changer and the evidence shows that all Australians stand to benefit.
Prof Brendan Crabb
President, Association of Australian Medical Research Institutes
Prof Brendan Crabb
President, Association of Australian Medical Research Institutes
The Association of Australian Medical Research Institutes (AAMRI) is the industry representative for Australia’s independent medical research institutes.
AAMRI’s 45 member organisations work on a broad spectrum of human health issues such as preventive health, chronic disease, mental health, immunology and Indigenous health. Their research ranges from fundamental biomedical discovery through to clinical research and the translation of research findings from bench to bedside.
AAMRI assists its members through advocacy, information provision, relationship building and member services.
AAMRI’s vision is hope, health and prosperity through health and medical research.